Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-544 - Vision care
VISION CARE - CLIENTS TWENTY YEARS OF AGE AND YOUNGER
Section 182-544-0325 - Vision care - Covered eyeglass frames and repairs-Clients age twenty and younger

Universal Citation: WA Admin Code 182-544-0325

Current through Register Vol. 24-18, September 15, 2024

(1)The medicaid agency covers durable or flexible frames when the client has a diagnosed medical condition that contributes to broken eyeglass frames. To receive payment, the provider must order the "durable" or "flexible" frames through the agency's designated supplier.

(2) The agency covers all of the following for clients :

(a) Coating contract eyeglass frames to make the frames nonallergenic. Clients must have a medically diagnosed and documented allergy to the materials in the available eyeglass frames.

(b) Four incidental repairs to a client's eyeglass frames in a calendar year. To receive payment, all of the following must be met:
(i) The provider typically charges the general public for the repair or adjustment;

(ii) The contractor's one year warranty period has expired; and

(iii) The cost of the repair does not exceed the agency's cost for replacement frames and a fitting fee.

(c) Up to two replacement eyeglass frames in a calendar year when the eyeglass frames have been lost or broken. Lost or broken eyeglass frames must be documented in the client's medical record.

11-14-075, recodified as §182-544-0325, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. 11-11-016, § 388-544-0325, filed 5/9/11, effective 6/9/11. Statutory Authority: RCW 74.08.090, 74.09.510, 74.09.520. 08-14-052, § 388-544-0325, filed 6/24/08, effective 7/25/08.

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